The Importance of Setting Specific Drive Parameters for Individuals

It’s never an easy task for anyone to
try something new or to immediately
excel in an area in which they have no
prior experience. For many individuals,
moving away from a personal comfort
zone can cause stress, anxiety and fear.
These situations can relate to many
aspects of a person’s daily life, and they
likewise ring true for many individuals,
including those with assistive technology
and mobility needs.

Rehab professionals are challenged
daily to ensure that they are providing
the most appropriate power mobility for
their clients. It’s imperative that the
client is not only physically comfortable
with his or her power chair, but
mentally comfortable, as well. In this
area, programming a power chair’s drive characteristics is a vital
part of the fitting process. The ultimate objective is to create an
optimal level of mobility that best serves the client’s clinical,
comfort and independence needs. Power chair handling plays a
key role in all of these areas.

Setting Clients Up for Success

For a moment, imagine trying to get comfortable going from your
own car to one that you’ve never driven.

You’d start by adjusting many aspects, like the seat, steering
wheel and mirrors. It would still take you quite some time to get
used to the overall handling. Based on this point, a client can have
initial difficulty operating, maneuvering and maintaining safety
with a new power chair. As rehab professionals, it is our responsibility
to ensure that we provide proper power chair drive training for all of our clients.

Some clients may be quick learners, and the drive training can
be simple. Others may require large amounts of time in order to
feel comfortable and be able to operate the power chair safely. In
all circumstances, however, setting the appropriate individual drive
settings can be the difference between remarkable liberation or
frustrating confinement for the client.

Although there are many variables associated with programming
drive parameters for specific client needs, there are three
client-centered aspects that need to be accomplished in order to
get successful results.

Driver Education

The first objective during initial drive trials with your client should
be taking 10-15 minutes at the beginning of the meeting to
explain the general workings of a power chair.

Many clients become very anxious about the thought of operating
a power chair. They can get scared if things do not go well,
and if something happens that the client doesn’t like from the
start, you may have a difficult time changing their mind as you
move on. Talk to the client about his or her expectations of how
the power chair should work and explain how the chair will react.
Make sure to thoroughly explain aspects like what a “proportional
joystick” means and how it will react when the client pushes it.
When we know how a device works, we’re more comfortable with
it, and your client will be too.

It is also extremely important to discuss with the client how to
stop the chair. Many clients have the tendency to try to stop a
forward motion by pulling back on the joystick — this situation
can be dangerous, causing the client to lose balance and control
of the chair. Educating the client to simply let go of the joystick to
stop can be a valuable piece of knowledge that keeps the client
comfortable with the power chair’s operation.

Start Out Slowly

The second objective is starting out slowly. The beauty of programmable
electronics is that you can have the drive parameters turned
down to a snail’s pace at the initial trial with the client.

It makes the operation of the power chair very safe, so that
the client is not immediately intimidated when driving for the
first time. It allows you room to increase parameters to the
client’s liking. If the power chair is programmed too fast for the
client at initial drive testing, they may become scared and not trust
it. This is difficult to recover from. Performing this objective may
take a bit more time in the beginning, but it may save you time by lessening repeat visits to a client who is not satisfied. And,
once again, building a client’s trust and confidence is vital.
Programming Speeds for All Environments
The third and final objective is to ensure that you program
through all speed modes for the client’s particular
environments.

The client needs to understand speed modes and how
they function. For example, if drive mode one is for the
client’s indoor use, you need to make sure that the drive
mode’s parameters fit that environment. To meet the client’s
needs, this may mean adjusting the parameters multiple times
while the client drives around his or her home until the drive
performance is acceptable to them. This same action should
be followed through all environment-based drive modes.

A Client-Centered Approach

As rehab professionals, surely we understand the technical
importance of drive parameter programming. However, it’s
vital that we also focus on the human side of the process —
the client.

When we take the time to follow a client-centered
method to programming, we see an amazing transition when
the client goes from apprehension to confidence with the
push of the joystick.

This article originally appeared in the February 2010 issue of Mobility Management.

About the Author

Jay Brislin, MSPT, is the director of Quantum Product and Clinical Development for the Quantum Rehab division of Pride Mobility Products (Exeter, Pa.). He can be reached via email at jbrislin@pridemobility.com or by phone at 800-800-8586.